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Preeclampsia is a pregnancy-specific hypertensive disorder characterized by new-onset hypertension and proteinuria after 20 weeks of gestation, affecting 3-5% of pregnancies. Eclampsia represents the severe progression of preeclampsia with the addition of seizures, constituting a life-threatening obstetric emergency requiring immediate intervention.
The condition results from abnormal placental implantation and spiral artery remodeling, leading to placental ischemia and release of anti-angiogenic factors like sFlt-1 and soluble endoglin. These factors cause widespread endothelial dysfunction, resulting in vasoconstriction, increased vascular permeability, and activation of the coagulation cascade throughout maternal organs.
Early recognition involves monitoring blood pressure trends, proteinuria assessment, and surveillance for warning symptoms like severe headaches, visual changes, or epigastric pain. Management focuses on blood pressure control with antihypertensives like labetalol or nifedipine, magnesium sulfate for seizure prophylaxis, and corticosteroids for fetal lung maturity when indicated. Delivery remains the definitive treatment, with timing based on maternal condition severity and fetal gestational age.